UN says Israeli attacks pushing Gaza healthcare to total collapse

The UN Human Rights Office says Israeli attacks on and around hospitals have pushed Gaza’s healthcare system to “the brink of total collapse” and raised serious concerns about war crimes and crimes against humanity.

A new report describes a pattern in which Israeli forces struck, besieged and forcibly evacuated hospitals, leading to patients dying or being killed.

It acknowledges Israel’s allegations that hospitals have been used by Palestinian armed groups, but says the evidence is “vague”.

Israel’s mission in Geneva said the report was an expression of what it called the UN Human Rights Office’s “politically-driven obsession with Israel“ and that it “relied on information from Hamas health authorities”. It stressed that Israeli forces operated in accordance with international law and would “never target innocent civilians”.

“It is the murderous terrorist organisation Hamas that uses civilians as human shields, and uses hospitals for terror activity,” it added.

It comes days after the last functioning hospital in besieged northern Gaza was raided by the Israeli military, which said it was being used as Hamas command centre.

Israel launched a campaign to destroy Hamas in response to the group’s unprecedented attack on southern Israel on 7 October 2023, in which about 1,200 people were killed and 251 others were taken hostage.

More than 45,500 people have been killed and 108,300 injured in Gaza since then, according to the territory’s Hamas-run health ministry.

“As if the relentless bombing and the dire humanitarian situation in Gaza were not enough, the one sanctuary where Palestinians should have felt safe in fact became a death trap,” UN High Commissioner for Human Rights Volker Türk said on Tuesday.

“The protection of hospitals during warfare is paramount and must be respected by all sides, at all times.”

The UN Human Rights Office (OHCHR) said it documented at least 136 strikes on 27 of the 38 hospitals in Gaza and 12 other medical facilities during the period covered by the report, which was between October 2023 and June 2024.

Those strikes claimed “significant casualties among doctors, nurses, medics and other civilians” and caused “significant damage, if not complete destruction of civilian infrastructure”, it added.

Medical personnel and hospitals are specifically protected under international humanitarian law, provided they do not commit, or are not used to commit, outside their humanitarian function, acts harmful to the enemy. Even then, any attack must still comply with the fundamental principles of distinction, proportionality and precautions in attack.

The OHCHR said intentionally directing attacks against hospitals and places where the sick and wounded were treated, intentionally directing attacks against the civilian population, and intentionally launching disproportionate attacks were war crimes.

And under certain circumstances, the deliberate destruction of healthcare facilities may also amount to a form of collective punishment, which would also constitute a war crime.

According to the report, in most instances where Israel has attacked hospitals, Israel has alleged that the hospitals were being improperly used by Palestinian armed groups.

“However, insufficient information has so far been made available to substantiate these allegations, which have remained vague and broad, and in some cases appear contradicted by publicly available information,” the UN report says.

“If these allegations were verified, this would raise serious concerns that Palestinian armed groups were using the presence of civilians to intentionally shield themselves from attack, which would amount to a war crime.”

Hamas and medical staff have denied that the hospitals have been used by armed groups.

The report also says that the impacts of Israeli military operations in and around hospitals have extended far beyond the physical structures.

“Many women are giving birth with no or minimal pre- and postnatal care, increasing the risk of preventable maternal and child mortality,” it says.

“OHCHR has received reports that a number of newborns died because their mothers were unable to attend postnatal check-ups or reach medical facilities to give birth.”

The report also says that people with trauma injuries were being prevented from receiving timely and possibly life-saving treatment, noting that the Gaza health ministry had reported an 80% decrease in the number of hospital beds and the killing of more than 500 medical professionals by the end of June.

“Many injured reportedly died while waiting to be hospitalized or treated. Even those who managed to receive critical treatment, including surgery, received it without proper bedding and facilities, and were often discharged prematurely due to a lack of space.”

The OHCHR cites the Israeli government as saying in response to the report that the Israeli military had taken “extensive measures” to “mitigate civilian harm and minimize disruption to medical services”.

These included enabling evacuation routes from hospitals, providing medical equipment, fuel and other aid to keep hospitals functioning, and establishing field hospitals, it said.

The Israeli government also asserted that Hamas had chosen to “to methodically abuse the protection of medical facilities”, “embeds its tunnel system and infrastructure within the premises of medical facilities as a matter of strategy, and utilizes them as arms caches and accessible HQs for its operatives”.

Türk called for independent investigations to be carried out into incidents documented in the report, and said it “must also be a priority for Israel, as the occupying power, to ensure and facilitate access to adequate healthcare for the Palestinian population”.